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Use this form to amend the advice related fees that are payable to your adviser and/or their licensee and deducted from your account.

Complete this form by typing directly into the relevant sections, then print off before signing, alternatively complete by using black pen – print in clear CAPITAL LETTERS. Use crosses [✘] in boxes where applicable.

1. ADVISER DETAILS

Please note that where the amendment is an increase in fees, then the client must sign this form. If the fees are being decreased, the adviser may sign.The fees provided on this form should include the desired amendment(s) as well as existing fees which are to be continued.

Adviser number

F Adviser name

2. INVESTOR DETAILS

Investor number

M

Investor name

3. ADVICE RELATED FEES

By completing this section and signing this form, you authorise and direct the Administrator and/or the Trustee to deduct and pay all of the fees listed in this section from your SuperWrap account to your adviser’s dealer group (or where the following paragraph applies, your adviser) on your behalf for financial advice and related services that your adviser and their dealer group provide you in relation to your SuperWrap account. You can negotiate the amount of these fees with your adviser. Typically, the Adviser Contribution fee should be up to 5% and the aggregate of the Licensee Advice fee and Ongoing Adviser fee should be up to 2% pa of the balance of your account, and the Administrator and/or Trustee have the right to reject a higher amount.In some cases your adviser and their dealer group may have an arrangement in place with us whereby 100% of certain advice related fees are intended to be paid to your adviser rather than your adviser’s dealer group.  If prior to you signing this form, your adviser requests you to agree to pay Adviser Contribution Fees and/or Ongoing Adviser Fees (Specified Fees) to them (rather than their dealer group), then by signing this form you agree that your authorisation and direction to pay fees in the previous paragraph is, to the extent it relates to Specified Fees, an authorisation and direction to pay those fees to your adviser.

a) ADVISER CONTRIBUTION FEE (For Personal Super Plan only)

EXISTING ADVISER CONTRIBUTION FEES TO APPLY

Complete the below:

Deducted from future ‘one-off’ contributions

Adviser contribution fee Effective date (MM-YYYY)

%l /Deducted from future regular contribution plans

Employer contributionsAdviser contribution fee Effective date (MM-YYYY)

%l /Member contributionsAdviser contribution fee Effective date (MM-YYYY)

%l /Spouse contributionsAdviser contribution fee Effective date (MM-YYYY)

%l /b) LICENSEE ADVICE FEE

You may only elect a Licensee advice fee where this fee type is offered in the PDS and your adviser’s dealer group has registered with us. Your adviser will confirm if this fee type is available to you. If you select this fee type and it is unavailable to you, we will set the amount requested to zero.

EXISTING LICENSEE ADVICE FEES TO APPLY

Complete the below:

If the boxes are left blank, the Licensee advice fee will be assumed to be zero. Please complete only either the Flat Fee or Sliding Scale option, not both. Fee amounts will be charged to your Cash account monthly and paid in arrears.

Effective date for Licensee advice fee to commence(MM-YYYY)

/

Please note: All changes are effective from the beginning of the month nominated.

Flat fee per annumDollar amount

$

and/orPercentage amount

Listed securities % pal

Managed funds % pal

Cash % pal

SuperWrapAdvice Related Fee Amendment Form

November 2016

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4. FEE DISCLOSURE ANNIVERSARY TRACKING

Adviser use onlyWould you like to track the Fee Disclosure Anniversary date via the Wrap DeskTop?Yes* Agreement start date / /No * By selecting “Yes” you are confirming that this client should be

tracked for Fee Disclosure Anniversary date purposes via the Wrap DeskTop. You can amend this status at any time through My Business>FOFA>Client Tracking.

Through this screen, you can also turn on the reminder email notifications which will alert you to when Fee Disclosure Statements are due.

5. SIGNATURE AND DECLARATION

The adviser indemnifies the Administrator against any claims, liabilities, losses, or reasonable expenses or costs suffered or incurred by the Administrator as a result of any such fees charged being improper, unreasonable, or not in accordance with the Administrator’s guidelines (issued from time to time) in respect of the advice or services that have been provided. The Administrator and the adviser agree that, to the extent that such fees charged are improper, unreasonable or not in accordance with the Administrator guidelines (issued from time to time) as reasonably determined by the Administrator in its absolute discretion, the adviser will repay the fee (or the relevant component) to the Administrator or the Administrator may set off an amount equal to that fee (or the relevant component) from any fee payable to the adviser (or the relevant dealer group).

I authorise the above changes to be made.

YOUR REQUEST CANNOT PROCEED IF THIS SECTION IS NOT SIGNED

Investor Signature

Date (dd/mm/yy)

/ /You can submit this form by:�

� mail GPO Box 2337, Adelaide SA 5001�

� fax (08) 8422 4415@ email wrapforms@btfinancialgroup.com

BT Funds Management Limited ABN 63 002 916 458 is the trustee and issuer of SuperWrap, which is part of Retirement Wrap ABN 39 827 542 991.

Sliding Scale per annumFrom $ To $ Percentage

$ Nil % pal

$ % pal

$ % pal

$ % pal

$ % pal

Is the sliding scale fee to include the balance in your Cash Account?If you don’t make a selection, the default is ‘No’.

Yes No

c) ONGOING ADVISER FEE

EXISTING ONGOING ADVISER FEES TO APPLY

Complete the below:

If the boxes are left blank, the Ongoing adviser fee will be assumed to be zero. Please complete only either the Flat Fee or Sliding Scale option, not both. Fee amounts will be charged to your Cash Account monthly and paid in arrears to your adviser.

Effective date for Ongoing adviser fees to comence.(MM-YYYY)

/Please note: All changes are effective from the beginning of the month nominated.

Flat fee per annumDollar amount

$

and/orPercentage amount

Listed securities % pal

Managed funds % pal

Cash % pal

Sliding Scale per annumFrom $ To $ Percentage

$ Nil % pal

$ % pal

$ % pal

$ % pal

$ % pal

Is the sliding scale fee to include the balance in your Cash Account?If you don’t make a selection, the default is ‘No’.

Yes No

Please note: These fees are quoted on a GST inclusive basis and represent the amounts which you agree to pay your adviser. The amounts deducted from your Cash Account will be adjusted to take account of the Reduced Input Tax Credits that are expected to be received in respect of these fees.